Facilities Application
(For facilities not currently listed with ELDERLINK)

To be a part of the ELDERLINK Referral Service, we need you to do the following:

Complete the form below, submit it by email or fax. After receipt of the form, you will receive the documents necessary to be listed with ELDERLINK Referral Service. Your facilities will be verified with the State of California to confirm the status of your license for our client's protection. ELDERLINK will contact you to assess your facility and a staff member will conduct an onsite tour. We look forward to working with you and assisting you with prospective clients. A tour will be arranged in the future.

ELDERLINK IS LICENSED BY THE DEPARTMENT OF HEALTH

ELDERLINK SERVES ALL OF CALIFORNIA
License#960000942   elderlink@elderlink.org - 310-396-5785 fax

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